title: Propofol sedation in total knee replacement : effects on oxidative stress and ischemia-reperfusion damage.
abstract: OBJECTIVE
  This study aimed to show the effect of propofol sedation on oxidative stress and inflammation resulting from ischemia-reperfusion.
  
  
  METHODS
  After having obtained written informed consent from the patients and ethics committee approval, 36 patients were randomly allocated to 2 groups: group C, control and group P, propofol. Spinal anesthesia was administered to both groups with 15 mg bupivacaine. Patients in group P received a propofol infusion of 2 mg/kgBW/h and the patients in group C received a placebo infusion in an equal dose. Malondialdehyde (MDA), superoxide dismutase (SOD) and the total antioxidative capacity (TAC) levels were measured in venous blood samples prior to propofol or placebo administration (preischemia T0), 30 min after placing the tourniquet (ischemia T1) and 2 h after deflation of the tourniquet (reperfusion T2). High sensitivity C-reactive protein (hsCRP) and neutrophil levels were measured before propofol was administered (T0) and 12 h after reperfusion (T3).
  
  
  RESULTS
  While serum MDA and SOD levels were significantly higher during the reperfusion period than the preischemic period, TAC levels were found to be low in the control group (p < 0.05). In the propofol group there were no differences between the preischemia-reperfusion periods with respect to MDA, SOD and TAC levels (p > 0.05). The neutrophil and hsCRP levels were observed to be increased to a lesser extent in the propofol group compared to the control group (p < 0.05).
  
  
  CONCLUSIONS
  Propofol infusion in addition to spinal anesthesia may reduce oxidative damage and the inflammatory response developing due to the tourniquet in total knee replacement surgery.
authors.affiliation: Department of Anaesthesia, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Koru M Kavakli S No:4/44, 06810, Ankara, Turkey. derya_z@yahoo.com
authors.forename: D
authors.initials: D
authors.lastname: Özkan
authors.forename: T
authors.initials: T
authors.lastname: Akkaya
authors.forename: A
authors.initials: A
authors.lastname: Yalcindag
authors.forename: T
authors.initials: T
authors.lastname: Hanci
authors.forename: E
authors.initials: E
authors.lastname: Gönen
authors.forename: H
authors.initials: H
authors.lastname: Gümüs
authors.forename: N
authors.initials: N
authors.lastname: Delibas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000378:metabolism; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016292:Procedural Sedation / Q000379:methods*; D004311:Double-Blind Method; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D008875:Middle Aged; D016877:Oxidants / Q000097:blood; D018384:Oxidative Stress / Q000187:drug effects; D015742:Propofol; D011446:Prospective Studies; D015427:Reperfusion Injury / Q000517:prevention & control*; D013482:Superoxide Dismutase / Q000378:metabolism
chemical_list: D000975:Antioxidants; D006993:Hypnotics and Sedatives; D016877:Oxidants; D008315:Malondialdehyde; D013482:Superoxide Dismutase; D015742:Propofol